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Gender disparities in access to care for time-sensitive conditions during COVID-19 pandemic in Chile
Jorge Pacheco1, Francisca Crispi2, Tania Alfaro2
1Departamento de Salud Pública, Universidad de Concepción, Víctor Lamas 1290 Casilla 160-C, 4070386, Concepción, Chile.
Insights
The COVID-19 pandemic caused significant reductions in healthcare access for time-sensitive oncologic and cardiovascular diseases in Chile. Women experienced greater access reductions than men, highlighting the need for a gender-informed health response.
Area of Science:
- Public Health
- Health Services Research
- Epidemiology
Background:
- Healthcare utilization decreased globally during the COVID-19 pandemic.
- Limited research exists on gender disparities in healthcare access amid the pandemic.
- This study addresses the gap by examining gender differences in access to time-sensitive care in Chile.
Purpose of the Study:
- To evaluate gender disparities in access to medical care in Chile during the COVID-19 pandemic.
- To analyze the impact of the pandemic on diagnoses of oncologic and cardiovascular diseases by gender.
Main Methods:
- An interrupted time series analysis using segmented regression was employed.
- Weekly confirmed cases of oncologic and cardiovascular time-sensitive conditions from 2017-2020 were analyzed.
- Stratified analysis by gender and age group was conducted to assess heterogeneity.
Main Results:
- A significant reduction in access to care for oncologic and cardiovascular diseases was observed.
- Women experienced a greater reduction in access compared to men for both disease categories.
- Specific conditions like myocardial infarction and colorectal cancer showed pronounced gender disparities in access reduction.
Conclusions:
- The COVID-19 pandemic led to a substantial decrease in diagnoses for time-sensitive conditions in Chile.
- Gender disparities were evident, with women facing more significant reductions in healthcare access.
- Policy-makers must integrate a gender perspective into pandemic response strategies to ensure equitable care.
Background:
During the COVID-19 pandemic, reductions in healthcare utilization are reported in different contexts. Nevertheless, studies have not explored specifically gender disparities in access to healthcare in the context of COVID-19.
Methods:
To evaluate gender disparities in access to medical in Chile we conducted an interrupted time series analysis using segmented regression. The outcome variable was the number of weekly confirmed cases of a set of oncologic and cardiovascular time-sensitive conditions at a national level. The series contained data from weeks 1 to 39 for 2017 to 2020. The intervention period started at week 12. We selected this period because preventive interventions, such as school closures or teleworking, were implemented at this point. We estimated the level effect using a dummy variable indicating the intervention period and slope effect using a continuous variable from weeks 12 to 39. To test heterogeneity by gender and age group, we conducted a stratified analysis.
Results:
We observed a sizable reduction in access to care with a slowly recovery for oncologic (level effect 0.323; 95% CI 0.291-0.359; slope effect 1.022; 95% CI 1.016-1.028) and cardiovascular diseases (level effect 0.586; 95% CI 0.564-0.609; slope effect 1.009; 95% CI 1.007-1.011). Greater reduction occurred in women compared to men, particularly marked on myocardial infarction (level effect 0.595; 95% CI 0.566-0.627 versus 0.532; 95% CI 0.502-0.564) and colorectal cancer (level effect 0.295; 95% CI 0.248-0.35 versus 0.19; 95% CI 0.159-0.228). Compared to men, a greater absolute reduction was observed in women for oncologic diseases, excluding sex-specific cancer, (1352; 95% CI 743-1961) and cardiovascular diseases (1268; 95% CI 946-1590).
Conclusion:
We confirmed a large drop in new diagnoses for time-sensitive conditions during the COVID-19 pandemic in Chile. This reduction was greater for women. Our findings should alert policy-makers about the urgent need to integrate a gender perspective into the pandemic response.
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